tbuckley/cabot-search huggingface dataset:
POS0418 ICE CRYOTHERAPY: A NEW STRATEGY TO REDUCE ARTERIAL INFLAMMATION IN RHEUMATOID ARTHRITIS? A STUDY IN ADJUVANT-INDUCED ARTHRITIS MODEL
Authors: C. Peyronnel, P. Totoson, V. Petitcolin, F. Bonnefoy, F. Verhoeven, X. Guillot, P. Saas, H. Martin, C. Demougeot
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) is characterized by endothelial activation (EA), endothelial dysfunction and vascular inflammation, leading to accelerated atherosclerosis. In the last decade, a renewed interest in cryotherapy - local or whole body - has emerged. Although growing evidence demonstrated that ice cryotherapy reduces not only pain but also disease progression, whether such therapy might blunt disorders of the systemic vasculature is unknown. Objectives The aim of our study was to determine the effects of a subchronic treatment with ice cryotherapy on aortic leucocyte infiltration and markers of endothelial activation in the rat adjuvant-induced arthritis (AIA) model. Methods AIA was induced by injection of Mycobacterium butyricum in Freund’s incomplete adjuvant at the base of the tail in 6-week-old male Lewis rats. AIA rats were treated or not with ice applied on paws, from the onset of arthritis to the acute inflammatory stage of the disease, twice a day for 14 days. Arthritis score and paw skin temperature were daily monitored. At the end of the treatment, leucocyte infiltration and the different cell subsets (monocytes/macrophages, neutrophils, CD4 + and CD8 + T cells producing or not IL-17A) were measured in thoracic aorta using flow cytometry. Relative mRNA expression of cytokines/chemokines (IL-6, TNF-α, CXCL-1, MIP-1α (CCL-3), MCP-1 (CCL-2)) and adhesion molecules (ICAM-1, VCAM-1) was analyzed in thoracic aorta by RT-qPCR. X-Ray analysis of hind paws was performed to assign a radiographic score. Results Treatment with ice cryotherapy, that decreased skin surface temperature from 28.6 ± 0.3°C to 18.5 ± 0.2°C, reduced arthritis score (-36%, p&lt;0.001) and radiographic score (-34%, p&lt;0.05) with a positive effect on osteoporosis, cartilage and bone destruction. These effects were associated with a dramatic decrease in CD4 + , CD8 + and Tc17 cell aortic infiltration as compared to untreated AIA. By contrast, ice had no effect on endothelial activation markers except VCAM-1 mRNA expression that was significantly increased (p&lt;0.05). A positive correlation was found between the number of total leucocytes, monocytes/macrophages, CD4 + and CD8 + T cells in aorta and arthritis score. Conclusion In the model of AIA that reproduces arterial wall inflammation recently characterized in rheumatoid arthritis by PET/CT [1], local ice cryotherapy exerts not only local beneficial effects on the joints but also systemic benefits on vascular inflammation in large vessels. These results suggest that reduction of vascular comorbidities might be a new output of ice cryotherapy used as an adjunctive therapy in RA. References [1]Agca et al. Rheumatology (Oxford ) (2021) Disclosure of Interests None declared.
AB0935 Number of patients with psoriatric arthritis (PsA) in Germany until 2040: Projection based on data from 65 million people in the German statutory health insurance
Authors: P. Sewerin, S. Knippschild, S. Tulka, X. Baraliakos, R. Brinks
Journal: Annals of the Rheumatic Diseases (2022)

Background Recently, we have reported an increase in the incidence and prevalence of patients with PsA in Germany based on claim data from 65 million people in statutory health insurance during 2009 to 2012 [1]. Objectives Population-based estimation of long-term projection for incidence and prevalence of patients with diagnosis of PsA until the year 2040. Methods Based on prevalence and incidence of PsA, the number of men and women diagnosed with PsA until 2040 is projected using the illness-death model [2]. The mortality and age distribution of the general population is taken from the official population forecasts of the German Federal Statistical Office. Mortality of patients with PsA was considered by using estimates of the mortality rate ratios [3]. Percent change in projected case numbers refer to 2012 (base year). Results Starting from 2012, three scenarios about the incidence of PsA after 2012 were found (Graph 1): (A) increase of 5% per year as observed in [1], (B) no trend in incidence and (C) decrease of a similar 5% per year due to a theoretically anticipated early treatment effect. In scenario C, the number of men and women peaks at about 2028 and decreases slightly afterwards. The graph shows the projected numbers of men (left panel) and women (right) with PsA until 2040 in the three incidence scenarios. The projected numbers and the percent changes are given in the Table 1. Conclusion Different scenario may be considered based on recent population data for the incidence course of PsA until 2040. The most optimistic scenario showed a trend of stabilization of incidence including the anticipated population mortality rates. Thus, it is likely that substantially more medical resources for treating patients with PsA are necessary in the next two decades, whereby approaches to the potential prevention of PsA, for example by very early treatment of psoriasis patients, should be further pursued. References [1]DOI 10.1136/rmdopen-2021-001975 [2]DOI 10.1016/j.tpb.2013.11.006 [3]DOI 10.1111/j.1365-2796.2010.02310.x Graph 1. Table 1. Scenario Sex Projected number 2019 (in 1000) Projected number 2040 (in 1000) Change 2040 compared to 2019 A Male 125 353 +183% Female 156 437 +180% B Male 116 173 +49.0% Female 146 223 +53.2% C Male 109 101 -6.9% Female 137 136 -0.5% Disclosure of Interests None declared
AB0933 Development and Validation of a Nomogram for Prediction of Nonalcoholic Fatty Liver Disease in Psoriatic arthritis
Authors: B. C. LI, R. Su, H. Yan, J. Liu, C. Wang
Journal: Annals of the Rheumatic Diseases (2022)

Background Psoriatic arthritis (PsA) has been linked to an increased risk of metabolic syndrome (MetS). Non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of MetS, is now the commonest liver disease worldwide. About 65% of PsA patients suffer from NAFLD, and chronic systemic inflammation may be an important predisposing factor. Objectives The purpose of this study was to establish and validate a diagnostic model nomogram for predicting the occurrence of NAFLD in patients with PsA. Methods A total of 127 PsA patients (46 had NAFLD and 81 had no NAFLD) were enrolled in this study. Retrospectively collected clinical and serological parameters of these patients. The percentage and absolute number of lymphocytes and CD4+T cells were determined by Flow cytometry. The independent risk factors for NAFLD were screened in the PsA patients using univariate and multivariate binary logistic regression analyses and were used for construction of the nomogram prediction model. The AUROC (C index) was used to verify the model discrimination; the calibration curve and Hosmer-Lemeshow test were used to verify the model calibration; and the DCA curve was used to verify the clinical validity of the model. Results Univariate and multivariate logistic regression analyses showed that Body Mass Index (BMI) (OR=1.25, P =0.001), serum triglyceride (TG) (OR=3.51， P =0.015) and peripheral blood Th1 cell percentage (OR=1.12, P &lt; 0.001) is an independent risk factor for NAFLD in PsA patients, and an individualized nomogram prediction model was successfully established. The prediction model had a good discrimination power with AUROC (C-index) of 0.83 (95% CI : 0.76-0.90); the P value in the Hosmer-Lemeshow test was 0.683, suggesting a high reliability of the predicted probability by the model; the DCA curve indicating a good clinical efficiency of the model. Conclusion Our study shows that the establishment of a nomogram prediction model of PsA complicated with NAFLD patients is helpful for early clinical screening and identification of such high-risk patients. Figure 1. A. Example of prediction nomogram for risk of PsA complicated with NAFLD patients; B. The ROC curve of the prediction model; C. The calibration curve of the prediction model; D. The decision curve analysis of the prediction model. Disclosure of Interests None declared
Diagnostic Performance of Electronic Noses in Cancer Diagnoses Using Exhaled Breath
Authors: Max H. M. C. Scheepers, Zaid Al-Difaie, Lloyd Brandts, Andrea Peeters, Bart van Grinsven, Nicole D. Bouvy
Journal: JAMA Network Open (2022)

There has been a growing interest in the use of electronic noses (e-noses) in detecting volatile organic compounds in exhaled breath for the diagnosis of cancer. However, no systematic evaluation has been performed of the overall diagnostic accuracy and methodologic challenges of using e-noses for cancer detection in exhaled breath.To provide an overview of the diagnostic accuracy and methodologic challenges of using e-noses for the detection of cancer.An electronic search was performed in the PubMed and Embase databases (January 1, 2000, to July 1, 2021).Inclusion criteria were the following: (1) use of e-nose technology, (2) detection of cancer, and (3) analysis of exhaled breath. Exclusion criteria were (1) studies published before 2000; (2) studies not performed in humans; (3) studies not performed in adults; (4) studies that only analyzed biofluids; and (5) studies that exclusively used gas chromatography-mass spectrometry to analyze exhaled breath samples.PRISMA guidelines were used for the identification, screening, eligibility, and selection process. Quality assessment was performed using Quality Assessment of Diagnostic Accuracy Studies 2. Generalized mixed-effects bivariate meta-analysis was performed.Main outcomes were sensitivity, specificity, and mean area under the receiver operating characteristic curve.This review identified 52 articles with a total of 3677 patients with cancer. All studies were feasibility studies. The sensitivity of e-noses ranged from 48.3% to 95.8% and the specificity from 10.0% to 100.0%. Pooled analysis resulted in a mean (SE) area under the receiver operating characteristic curve of 94% (95% CI, 92%-96%), a sensitivity of 90% (95% CI, 88%-92%), and a specificity of 87% (95% CI, 81%-92%). Considerable heterogeneity existed among the studies because of differences in the selection of patients, endogenous and exogenous factors, and collection of exhaled breath.Results of this review indicate that e-noses have a high diagnostic accuracy for the detection of cancer in exhaled breath. However, most studies were feasibility studies with small sample sizes, a lack of standardization, and a high risk of bias. The lack of standardization and reproducibility of e-nose research should be addressed in future research.
AB0504 DOES THE PRESENCE OF ANTIPHOSPHOLIPID ANTIBODIES AFFECT THE PROGRESSION OF RENAL FAILURE IN PATIENTS WITH LUPUS NEPHROPATHY? LONG-TERM OBSERVATION
Authors: E. Łyś, D. Suszek, M. Majdan
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic lupus erythematosus (SLE) is a systemic autoimmune disorder with various clinical manifestations and diverse courses. Lupus nephropathy (LN) is observed in 30-50% of patients with SLE. 10% of patients with LN will develop renal failure (RF). Antiphospholipid antibodies (aPLs) are known for their pro-thrombotic action. According to the literature data, the presence of aPLs can lead to the development of thrombotic microangiopathy and may influence the progression of RF among patients with LN. Objectives The study aims to assess the influence of the presence of aPLs on the course and the progression of LN in long-term observation. Methods We conducted a retrospective analysis of the medical history of 34 patients (pts) with SLE and confirmed lupus nephropathy who are under the constant, long-term care of a rheumatology center. The kidney function (creatinine, estimated glomerular filtration rate; eGFR) was assessed at the beginning of the observation and after approximately 7-10 years. The presence of antiphospholipid antibodies (anticardiolipin antibodies IgG or IgM, anti-beta-2-glycoprotein-I antibodies IgG or IgM, lupus anticoagulants) was taken into consideration. The progression of RF was compared between the pts groups with positive and negative aPLs test results. Results A total of 34 patients (median age at the end of follow-up was 50 years; range 24-82) were included. The majority of patients were female (88.2%). Of these patients, 8 (23.5%) had a positive tests for aPLs many times in their medical history. Considering the progression of RF among patients with positive aPLs, significant statistical differences were observed (p &lt;0,01). Moreover, a statistically significant effect of aCL (p &lt;0.03) and antibodies directed against anti-beta2 glycoprotein I (p &lt;0.04) on the reduction of eGFR in the course of the disease was observed. Conclusion The presence of aPLs is associated with the risk of the deterioration of kidney function in patients with LN. It affects the decrease of eGFR and an increase of the concentration of creatinine in the blood. References [1] Morales E., Galindo M. Et al. Update on Lupus Nephritis: looking for a new vision. Nephron 2021;145:1:1h [2] Zhang J., Zhang Ji., et al. Association of antiphospholipid antibodies with clinical activity and renal pathological activity in patients with lupus nephritis. Lupus. 2021;30(7):1140-1145. [3] K. Talari, U. Anandh, A. Patric. Lupus Nephritis with Coexistent Antiphospholipid Antibodies Associated Nephropathy: A Case Report and Literature Review. Indian J Nephrol. 2018; 28(2): 164–166. Disclosure of Interests Ewa Łyś: None declared, Dorota Suszek: None declared, Maria Majdan Speakers bureau: Medac, Novartis, Sandoz, Consultant of: Sandoz, AstraZeneca
AB1193 THE COURSE OF COVID-19 INFECTION IN PATIENTS WITH RHEUMATOID ARTHRITIS RECEIVING VARIOUS BIOLOGICAL DISEASE-MODIFYING ANTIRHEUMATIC DRUGS
Authors: R. Samigullina, A. Dadalova, E. Vasilenko, V. Mazurov
Journal: Annals of the Rheumatic Diseases (2022)

Background With the ongoing COVID-19 pandemic, the safety of biologic disease-modifying antirheumatic drugs in patients with rheumatic disease remains an important issue. Objectives to assess the course of COVID-19 infection in patients with rheumatoid arthritis receiving various biological disease-modifying antirheumatic drugs. Methods An analysis was made of the course of COVID-19 in patients with rheumatic diseases who were under observation at the North-Western State Medical University. I.I. Mechnikov in the period from March 2020 to November 2021. During this period, 198 (14.04%) cases of COVID-19 were registered out of 1389 patients included in the registries of the anticytokine therapy center. Among patients with rheumatoid arthritis who recovered from COVID-19 infection, 105 cases were registered, of which 53 patients received outpatient treatment, and 52 patients received inpatient treatment. In 76% of cases, patients received biological DMARDs in combination with synthetic DMARDs. Results Exacerbation of the articular syndrome was observed only in 12 (11.4%) patients with RA during COVID-19. The low percentage of exacerbations in patients with RD on the background of COVID-19 was probably associated with the use of dexamethasone at a dose of 16-32 mg, which has the ability to reduce the activity of the immune-inflammatory process in rheumatic diseases. This statement is confirmed by the fact that out of 52 patients with RA who were hospitalized for COVID-19, 16 patients (30.8%) received dexamethasone intramuscularly or intravenously, and 8 patients (15.4%) continued oral administration of this drug. Table 1. The course of COVID-19 infection in RA patients treated with various biological DMARDs. Severity and outcomes of COVID-19 All patients (n=105 ) N (% ) Abatacept (n=11 ) N (% ) Rituximab (n=56 ) N (% ) IL-6 inhibitors (n=9 ) N (% ) TNF-alpha inhibitors n=15 N (% ) JAK inhibitors n=17 N (% ) No hospitalization required 53 (50,5) 3 (27,3) 19 (33,9) 8 (88,9) 12 (80) 11 (64,7) Hospitalization without oxygen support 31 (29,5) 5 (45,5) 18 (32,1) 1 (11,1) 3 (20) 4 (23,5) Hospitalization with oxygenation or mechanical ventilation 24 (22,8) 3 (27,3) 19 (33,9) 0 0 2 (11,8) Death 5 (4,8) 1 (9,1) 4 (7,1) 0 0 0 Conclusion The use of rituximab was associated with a more severe course of COVID-19, which required hospitalization in 66% of cases, compared with the group of patients treated with TNF-α inhibitors, in which hospital treatment was carried out only in 20% of cases. The introduction of blockers of co-stimulation of T-cells, IL-6 inhibitors, targeted synthetic drugs did not affect the severity of COVID-19. Disclosure of Interests None declared
AB0900 A temporary antirheumatic drugs withdrawal does not cause an excess of disease flares in patients with psoriatic arthritis undergoing Covid-19 mRNA vaccination
Authors: R. Bixio, A. Milanesi, O. Viapiana, C. Montecucco, S. Bugatti, M. Rossini
Journal: Annals of the Rheumatic Diseases (2022)

Background The best way to manage disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatic and musculoskeletal diseases (RMDs) undergoing the Coronavirus disease (Covid)-19 vaccination and the recommendations regarding the use and timing of immunomodulatory therapies around the time of vaccination are still a matter of debate, due to the difficulties in balancing the vaccination efficacy and safety. Objectives To assess the impact of different strategies of antirheumatic treatment management on disease activity around the time of vaccination for Coronavirus disease (Covid)-19 in patients with psoriatic arthritis (PsA). Methods We prospectively evaluated patients with PsA in remission or low-disease activity candidate to receive Covid-19 vaccination with mRNA vaccines. Methotrexate (MTX) and leflunomide were withheld 7 days after each dose, whilst biological DMARDs (bDMARDs), were either continued (46.8% of the patients) or withheld (53.2%) from the day of the first dose until 7 days after the second dose. Patients were reassessed after 3 months from enrollment or in case of disease flare. Results After the second dose of Covid-19 vaccination 7 patients (5.6%) (6 females) had an articular disease flare each (mean involved joints: 1.29), one patient presented a concomitant worsening of psoriasis, and four patients had an isolated worsening of their psoriasis. All patients received additional treatments with oral GC (n=2) or non-steroidal anti-inflammatory drugs (n=5). Two flares lasted more than one week and required a modification of the ongoing bDMARD. Articular flare incidence (6.8% vs 3%, p=0.259), involved joints (1.4 vs 1.5, p=0.846), disease flare severity, and changes in antirheumatic therapies (1 vs 1, p=0.928) did not differ significantly between the two different bDMARD management strategy groups (continued vs temporary withheld). There was no significant difference in disease activity score for psoriatic arthritis (DAPSA) and C-reactive protein (CRP) after vaccination, but patients who flared up had a higher mean basal DAPSA (7.3 vs 4.1, p=0.046). On binomial logistic regression analysis, we did not find any significant association with gender, age, basal CRP, basal DAPSA, active psoriasis, conventional synthetic DMARDs, or bDMARDs and disease flare. Conclusion Our findings suggest that a temporary short halt of bDMARDs could be a viable option in patients with well-controlled PsA undergoing Covid-19 vaccination without increasing the risk of flares, which could be useful to increase T cell response and antibody titres after Covid-19 vaccination. Disclosure of Interests None declared
POS1131 ASSOCIATION BETWEEN ANTIBIOTIC USE AND RADIOGRAPHIC PROGRESSION OF OA: DATA FROM THE OSTEOARTHRITIS INITIATIVE
Authors: I. Shirinsky, V. Shirinsky
Journal: Annals of the Rheumatic Diseases (2022)

Background Gut dysbiosis has been proposed as one risk factor for osteoarthritis (OA) (1).To date, there have been no studies assessing association between the use of antibiotics and structural progression of knee OA. Objectives To evaluate association between the use of antibiotics and radiographic progression of knee OA. Methods For the current study we used 9-year longitudinal data obtained from the Osteoarthritis Initiative (OAI) progression (n= 1390) and incidence (n = 3284) subcohorts, which are publically available at https://oai.nih.gov . For the assessment of antibiotic influence on knee OA progression we analyzed all knees having baseline JSN&lt;3 from both subcohorts. The main outcome was knee OA progression (defined as increase in semiquantitative JSN or a new knee replacement). To acquire information about the use of antibiotics, a medication inventory method was used. We excluded participants who used antibiotics at or 30 days prior to baseline (a “new-user” design). Antibiotic users were defined as those with at least one recorded use during first four years of the study. Other participants who did not use antibiotics prior to baseline and throughout the observation period were classified as non-users. Logistic regression models were used to evaluate the relationship between the outcome and antibiotic use. Generalized estimating equations (GEE) were used to adjust for the correlation between knees. Results A total of 8415 of knees (7404 non-user knees and 1011 user knees) were included in the analysis. No association between the use of antibiotic and radiographic progression of knee OA was found (odds ratio 1.23, 95% confidence interval 0.59-2.56, p = 0.59). No associations were also observed in multiple stratified analyses based on different duration of antibiotic use, particular classes of antibiotics, or different baseline KL grades. Conclusion These findings do not support the effects of antibiotics on knee OA progression. References [1]Hao, X., Shang, X., Liu, J. et al. The gut microbiota in osteoarthritis: where do we stand and what can we do?. Arthritis Res Ther 23, 42 (2021) Acknowledgements I have no acknowledgements to declare Disclosure of Interests None declared
AB0437 MONTELUKAST AS A TREATMENT FOR REFRACTORY CUTANEOUS LUPUS ERYTHEMATOSUS: A CASE SERIES AND PROOF-OF-CONCEPT STUDY
Authors: F. A. Castro Rocha, I. Nogueira, R. Nunes, G. da Silva, C. Martins
Journal: Annals of the Rheumatic Diseases (2022)

Background Treatment of cutaneous lupus relies mostly in avoidance of exposure to sunlight, steroids and hydroxychloroquine. A diverse array of cytokines and chemokines released by resident and migrating inflammatory cells have been implicated in the pathogenesis of skin damage in patients with systemic lupus erythematosus (SLE). Leukotrienes are potent lipid mediators involved in hypersensitivity reactions but very few data exist on their involvement in SLE. Objectives Our aim is to report a case series of SLE patients with refractory skin lesions that were successfully treated with sodium montelukast (MLK), a cysteinyl-leukotriene antagonist. Methods We present 4 consecutive female SLE patients with refractory skin lesions that were treated with MLK (10mg/d). Skin lesions were scored using CLASI criteria. Peripheral blood mononuclear cells (PBMC) from those 4 SLE patients and 4 healthy age-matched female controls were collected and the relative expression of the 5-lipoxigenase (ALOX5) and 15-lipoxigenase (15LOX1R) genes against a reference gene (GAPDH) was assessed using a quantitative polymerase change reaction (qPCR) protocol. Results All four patients experienced improvement of skin lesions 2-4 weeks following initiation of MLK with over 50% reduction in severity using CLASI score. The response was sustained for at least 3 months follow-up and no adverse events were recorded. All but one of the patients relapsed following MLK withdrawal but response was recovered after restart of MLK. Expression of the ALOX5, but not of 15LOX1R, was significantly (p&lt;0.001) increased in PBMC from SLE patients as compared to controls. Conclusion This is the first report of a fast and sustained successful response of cutaneous SLE to MLK. There were no safety issues. PBMC from SLE patients showed increased expression of the ALOX5gene. This case series suggests the involvement of MLK in cutaneous lupus and encourage designing a randomized trial. Disclosure of Interests None declared